From the Guidelines
Folliculitis of the scalp should be treated with over-the-counter medicated shampoos containing ketoconazole 1% (like Nizoral), selenium sulfide, or pyrithione zinc, used daily for 1-2 weeks, as this approach has been shown to be effective in managing the condition 1. For mild cases, this treatment is usually sufficient, and it is essential to apply warm compresses to affected areas for 15-20 minutes several times daily to reduce inflammation.
- Key considerations in the treatment of folliculitis of the scalp include:
- Avoiding scratching and sharing personal items like combs or hats
- Using gentle, fragrance-free hair products
- Managing underlying conditions like seborrheic dermatitis
- Avoiding tight headwear
- If symptoms worsen or don't improve after a week of treatment, it is crucial to consult a healthcare provider for further evaluation, as they may prescribe topical antibiotics like clindamycin 1% solution or oral antibiotics such as doxycycline or cephalexin 1. The condition occurs when bacteria (commonly Staphylococcus aureus) enter hair follicles through small breaks in the skin, causing inflammation, and proper hygiene is essential in preventing recurrence 1.
From the Research
Folliculitis Scalp
- Folliculitis is a bacterial infection involving inflammation of the hair follicle and the perifollicular tissue 2
- It can be caused by bacterial or fungal infections, and can also be a result of other conditions such as pseudofolliculitis barbae (PFB) or follicular contact dermatitis 3, 4, 5
- Symptoms of folliculitis can include papules, pustules, and inflammation around the hair follicles, and can be treated with topical or oral antibiotics, antifungals, or other medications 2, 3, 6
Treatment Options
- Topical antibiotics, such as cefadroxil or flucloxacillin, may be effective in treating bacterial folliculitis 2
- Oral antifungals, such as azithromycin, may be effective in treating fungal folliculitis 3
- Tetracyclines have been recommended for the prophylaxis and treatment of folliculitis induced by EGFR inhibitors 6
- Behavioral changes, such as altering shaving habits, and the use of topical therapies may also be effective in treating PFB 5
Causes and Risk Factors
- Bacterial folliculitis can be caused by Staphylococcus aureus or other bacteria 2
- Fungal folliculitis can be caused by Malassezia yeast 3
- PFB can be caused by hair follicles penetrating the skin and causing an inflammatory response, and is more common in individuals with curly hair 5
- Follicular contact dermatitis can be caused by allergens or irritants, including topical antibiotics such as neomycin 4